2025 ICD-10-CM code Z31
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Factors influencing health status and contact with health services - Persons encountering health services in circumstances related to reproduction Chapter 21: Factors influencing health status and contact with health services Feed
Encounter for procreative management.
Modifiers may be applicable depending on the specific services provided and the context of the encounter.Refer to the most up-to-date coding guidelines for specific modifier usage.
Medical necessity for Z31 is established based on the patient's need for services related to procreative management.This could include assessing fertility, providing contraception guidance, or counseling on sterilization options. The specific reason for the encounter must be clearly documented to justify the medical necessity.
The clinical responsibility varies depending on the specific services provided, and may involve physicians specializing in reproductive endocrinology and infertility, obstetricians and gynecologists, or family physicians.
- Chapter 21: Factors influencing health status and contact with health services
- Z30-Z39: Persons encountering health services in circumstances related to reproduction
In simple words: This code is used when someone goes to a doctor or clinic for help with getting pregnant or avoiding pregnancy.It doesn't include problems related to infertility or complications from fertility treatments.
This code signifies an encounter for the purpose of managing procreation, encompassing various services and interventions aimed at achieving or preventing pregnancy.It excludes complications of artificial fertilization (N98.-), female infertility (N97.-), and male infertility (N46.-).
Example 1: A 30-year-old female patient consults a reproductive endocrinologist for pre-conception counseling, including assessment of her overall health and lifestyle factors affecting fertility., A couple undergoes in-vitro fertilization (IVF) procedures.The code Z31 is used to describe the encounter for IVF monitoring and management, excluding the actual IVF procedure itself, which would require separate procedural codes., A 42-year-old female patient seeks consultation regarding sterilization options (tubal ligation), and receives counseling on the procedure and its implications. The code Z31 is used to reflect the counseling encounter, while a separate procedural code would be used to represent the tubal ligation.
Detailed medical history focusing on reproductive health, including past pregnancies, menstrual cycles, sexual history, and relevant family history. Results of any investigations such as blood tests, ultrasound scans, or genetic tests. Documentation of any counseling provided related to reproductive health, including methods of contraception, fertility treatments, or sterilization options.Complete documentation of any procedures performed, even if minor, such as intrauterine device insertion or removal, using appropriate procedural codes.
** This code is used for encounters specifically focused on procreative management.If the encounter addresses other medical issues unrelated to procreation, those should be coded separately.Always refer to the current ICD-10-CM coding guidelines for proper usage.
- Payment Status: Active
- Modifier TC rule: Not applicable to diagnosis codes.
- Specialties:Obstetrics & Gynecology, Reproductive Endocrinology & Infertility, Family Medicine
- Place of Service:Office, Clinic, Hospital (inpatient or outpatient)